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Among the people and programs coming in for prominent media coverage in recent months was Elliott Fisher, a professor of medicine and the lead author of a major study on Medicare spending patterns. "Increased Medicare spending does not necessarily translate into superior quality of care or improved health," said the New York Times of Fisher's study. "On most measures, both the quality of care and outcomes of care were better in the more conservative regions," Fisher told National Public Radio's All Things Considered. And the Wall Street Journal wrote: "The federal Medicare program spends about 60% more for health care for bene- ficiaries in White Plains, N.Y., and Detroit than it does in Rochester, N.Y., and Grand Rapids, Mich. . . . 'The belief that more medical care is better is deeply entrenched in our system,' says Elliott Fisher." See page 3 for more on his study.

The same theme, in a different patient population, was the subject of a story by the European wire service Reuters: "When it comes to having doctors who specialize in the medical problems of premature infants, a new study suggests that more is not necessarily better. A research team from Dartmouth found that premature babies were just as likely to survive in regions of the United States where the number of specialists and special neonatal care units was below average, compared to regions where the number was high." The article quoted researcher David Goodman, M.D., as saying, "It's possible that babies can be harmed if they are subjected to too much specialized care." See the Fall 2002 issue for more on this study.

An Atlantic Monthly feature quoted DMS's pioneering outcomes researcher: "'There is a certain level of care that helps you live as long and as well as possible,' says Dr. John Wennberg, director of the Center for the Evaluative Clinical Sciences at Dartmouth Medical School. 'Then there's excess care, which not only doesn't help you live longer but may shorten your life or make it worse.'"

Parenting magazine, in an article about what makes for a rewarding birth experience, addressed the decline in vaginal births after cesareans, or VBACs: "Many medical experts are concerned that women aren't offered the option of a VBAC as often as they should be. 'Three out of four women who've had a prior C-section could probably deliver vaginally. Yet doctors and hospitals are eliminating this option because of a lack of clear national guidelines and the threat of malpractice,' says Michele Lauria, M.D., an associate professor of obstetrics and gynecology at Dartmouth. . . . 'Women should have a choice about VBACs.'"

Another aspect of motherhood was the subject of a feature in the Dallas Morning News. "An estimated 20 percent of women will experience depression sometime in life—disproportionately in the childbearing years. And the disease underlies many of the problems families struggle with in their children, says Dr. Ardis Olson, a professor of pediatrics at Dartmouth. 'Mothers who are depressed report more child behavior problems in the first year of life, they report more difficulty connecting to their children . . .,' she says. Depressed mothers are also less likely to read to their children, to discipline them consistently, and to protect their health and safety with measures such as seat belts, Dr. Olson says."

A front-page story in the New York Times science section focused on new findings about RNA's role in the cell. "Some genes, scientists found, produce tiny RNAs, known as micro- RNAs. . . . The first such micro- RNA was discovered in the early 1990s by Dr. Victor Ambros and his colleagues at Dartmouth. Because the finding was so unexpected, 'there was a considerable amount of legitimate doubt,' Dr. Ambros recalled." See page 6 in this issue for evidence that there is no longer any doubt.

A DMS expert on the safety of the blood supply was quoted recently in the Wall Street Journal: " 'Two-thirds of the [transfusion] problems take place at the bedside,' says Dr. James AuBuchon, who runs the blood bank at Dartmouth." And in the Atlanta Journal- Constitution: "Self-donation dropped in the '90s as the public gained more confidence in the blood supply, said Dr. James AuBuchon." See page 26 for more on the subject.

The Boston Globe took a look at "the infamous Oedipal complex," saying experts now advise against reading too much into children's behavior. "The danger . . . is that by overreacting, we shame our sons. 'That can deprive them of a chance to grow emotionally,' says child and adolescent psychiatrist Dr. Robert Racusin of Dartmouth. . . . For those moments that do look like sexualized behavior toward mom or jealousy toward dad, Racusin tells parents to deconstruct it: 'Why would he be jealous? Does he really want to see his father displaced, or is it more likely that he's looking to fulfill the innate human need to have connection?'"

The New York Times got expert commentary on a new online alcohol-education program aimed at college students. "'Having some sort of basic way of educating students about alcohol makes a lot of sense,' said Dr. Jack Turco, director of health services at Dartmouth College [and an associate professor of medicine at DMS]. But with an incoming class of 1,100 students, 'it's next to impossible to get individual classes and enough people to teach them.'"

The New York Times recently focused on "what some patients call 'chemo brain,'" citing growing evidence that "chemotherapy can, in some cases, cause problems with memory and concentration. . . . Dr. Tim Ahles, a psychologist at Dartmouth, said, 'Part of the reason that this whole issue is coming more to the fore now is that we're seeing increasing numbers of long-term cancer survivors who are wanting to get back to their routines, so increasing numbers of people are having problems.'"

The world is still beating a path to the door of Dr. Heinz Valtin, almost a year after word leaked out that he had debunked the dictum to drink eight 8-ounce glasses of water a day. Noted Reader's Digest: "There's no proof we all need to drink '8x8'—eight 8- ounce glasses of water—each day, according to Dartmouth Medical School physiologist Heinz Valtin." Reported Health magazine: "Valtin says that cotton-mouthed feeling generally kicks in before your body gets significantly dehydrated." And The Guardian of London got Valtin to reveal his own drinking habits: "The two-litres-aday mantra has recently been challenged by a number of respectable sources. Professor Heinz Valtin (who drinks just one glass of plain water a day, plus about five glasses of juice, coffee, milk, and other fluids), is a kidney specialist at Dartmouth Medical School in America." See the Fall 2002 issue for more about Valtin's conclusions.

The media turned for commentary on January's space shuttle tragedy to two Dartmouth faculty members. Jay Buckey, M.D., an associate professor of medicine and a former astronaut, shared the perspective of someone who'd flown on Columbia in a New York Times op-ed essay: "It is important to remember that the Columbia crew ventured into space for a purpose, to do experiments needed for long-duration space flights." And the Psychology Today Web site speculated about the state of mind of the three astronauts on the international space station: "'They knew they might experience a serious personal loss while in space, and they accept that,' says James Carter, Ph.D., of Dartmouth Medical School. . . . Even so, NASA is concerned about the psychological rami- fications of long-duration missions—such as a possible trip to Mars. Carter is now working with NASA in developing virtual reality therapy for astronauts." See the Winter 2002 issue for more about that project.

"How safe is your hospital?" was a recent headline in Consumer Reports. The magazine known for its ratings of washing machines and cars didn't rank hospitals but did offer advice on how to determine the quality of a given hospital: "The amount of experience a hospital or doctor has with a particular health condition seems to play a key role in the quality of care delivered. A 2002 study headed by John Birkmeyer, M.D., chief of general surgery at Dartmouth- Hitchcock Medical Center, found that the risk of death following surgery for pancreatic cancer—an especially difficult operation —is 360% greater at the lowest-volume hospitals than at the highest-volume ones."

The possibility that within a decade there may be a "morning-after pill" to prevent post-traumatic stress disorder was reported in the Milwaukee Journal-Sentinel. Researchers have focused on the naturally occurring brain chemical neuropeptide Y, which "helps buffer the effects of stress and anxiety. 'If we could somehow bottle it or train people to mobilize their own neuropeptide Y, that would be great primary prevention,' said Dr. Matthew Friedman, speaking at the American Association for the Advancement of Science's annual meeting in Denver." See the Winter 2001 issue for a profile of Friedman, who is a professor of psychiatry and of pharmacology at DMS.

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